Diagnóstico prenatal de tumores congénitos intracraneales: teratoma inmaduro / Prenatal diagnosis of congenital intracranial tumors: Immature teratoma

Los tumores fetales intracraneales son poco frecuentes. La mayoría se localizan a nivel supratentorial. Los tipos más frecuentes encontrados son los teratomas. Suelen sospecharse por ecografía obstétrica, siendo los signos más frecuentes macrocefalia, hidrocefalia, ventriculomegalia, polihidramnios y masa intracraneal. De forma global, su pronóstico es infausto, dependiendo del tamaño y del tipo histológico del tumor. Presentamos el caso de un feto de 32 semanas de edad gestacional con diagnóstico ecográfico de tumoración intracraneal, cuyo resultado histológico confirmó teratoma inmaduro congénito (AU)

Fetal intracranial tumors are uncommon and are mostly located in the supratentorialregion. The most frequent forms are teratomas. These neoplasms are usually suspected on the basis of obstetric ultrasound examination, the most frequent signs being macrocephaly, hydrocephalus, ventriculomegaly, polyhydramnios and intracranial mass. Prognosis is generally poor, depending on tumoral size and histological type. We report the case of a 32-week fetus with an ultrasonographic diagnosis of intracranial tumor. The histological analysis confirmed the presence of a congenital immature teratoma (AU)

Expression of HLA molecules on peripheral blood lymphocytes: a useful monitoring parameter in cardiac transplantation.

During the rejection process of cardiac allografts, the expression of HLA antigens increases on various graft tissues, ie, the myocardium and the interstitial structures. However, in this type of transplant there is a paucity of knowledge about HLA expression on recipient cells, such as peripheral blood mononuclear cells. In the present study expression of HLA class I and class II antigens was monitored on peripheral blood lymphocytes prior to and during a 12-month follow-up, using flow cytometry. In our series, the frequency of acute rejection episodes was greater from the fourth to the ninth month after transplantation, coinciding with a reduction in cyclosporine blood levels. At the same time, expression of HLA class I and class II antigens significantly increased among recipients suffering from more severe acute rejection episodes compared with those showing acceptance of their grafts (P < .01). In conclusion, acute rejection episodes in cardiac transplantation were associated with up-regulation of HLA molecules on recipient peripheral blood cells. Monitoring the expression of HLA molecules on peripheral blood lymphocytes may represent an easy, noninvasive practice to individualize immunosuppressive therapy.

Cystic mature teratoma of the filum terminale in an adult. Case report and review of the literature.

Intradural spinal teratoma is a very rare entity, more prevalent in childhood, that may associate with dysraphic defects. The authors report a 46 years old man with a cauda equina syndrome and an L1-2 tumor. An L1-2 laminectomy was performed and a mass was resected at the base of the filum terminale, which was in contact with the conus medullaris. Histopathological diagnosis was of cystic mature teratoma. Spinal teratomas may be found anywhere along the spine, but are more frequent in the cauda equina. We discuss the origin of these tumors and review the literature concerning these lesions.

Carcinoma neuroendocrino de timo (carcinoide tímico): descripción de un nuevo caso y revisión de la literatura / Neuroendocrine carcinoma of the thymus (thymic carcinoid): report of a new case and review of the literature

Presentamos las características clínicas, procedimientos diagnósticos y estudios histológicos y de inmunohistoquímica empleados en la valoración y tratamiento de un inusual caso de carcinoma neuroendocrino de timo (carcinoide tímico). Se trataba de una gran masa mediastínica anterosuperior, descubierta accidentalmente durante la realización de una técnica de imagen a una mujer de 54 años. Pese a su aparente benignidad, por la ausencia de clínica o endocrinopatía asociada, por su aspecto macroscópico y encapsulamiento, sugerimos que, tras el preciso diagnóstico obtenido mediante punción aspiración con aguja fina (PAAF) bajo control de tomografía computerizada (TC) y su posterior exéresis completa, se realice un estrecho y continuado seguimiento en el tiempo, dada la singular agresividad que le caracteriza. (AU)

[Acute lipoid pneumonia caused by accidental aspiration of vaseline used in nasogastric intubation]. / Neumonía lipoidea aguda debida a la aspiración accidental de vaselina utilizada en un sondaje nasogástrico.

Exogenous lipoid pneumonia is a rare disease which is often underdiagnosed. Exogenous lipoid pneumonia has traditionally been considered a chronic process secondary to continued aspiration or inhalation of fatty substances. In its acute form exogenous lipoid pneumonia sometimes coincides with accidental massive aspiration of lipidic material, as has been traditionally described for fire eaters. We review the literature and report a case of acute lipoid pneumonia secondary to accidental aspiration of vaseline used to place a nasogastric tube, which had been inserted for gastric lavage after a suicide attempt by flurazepam ingestion.